Request for information on employment/self-employment/residence periods

M052 - Request for information on employment/self-employment/residence periods - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004

SED API version: 0.15.3 build preview 1
Model version: 4.1.0

1. Person *

1.1. Person Identification *

1.1.1. Family name(s) *

1.1.2. Forename(s) *

1.1.3. Date of birth *

1.1.4. Sex *

1.1.5. Family name(s) at birth

1.1.6. Forename(s) at birth

1.1.7. PIN of the person in each institution

1.1.7.1. Personal Identification Number(s) *

1.1.7.1.1. Country *

1.1.7.1.2. Personal Identification Number (PIN) *

1.1.7.1.3. Sector

1.1.7.1.4. Institution

1.1.7.1.4.1. Institution ID *

1.1.7.1.4.2. Institution Name *

1.1.7.1.Personal Identification Number(s)

1.1.8. If PIN not provided for every institution, please provide

1.1.8.1. Place of birth

1.1.8.1.1. Town *

1.1.8.1.2. Region

1.1.8.1.3. Country *

1.1.8.2. Father's family name at birth

1.1.8.3. Forename of father

1.1.8.4. Mother's family name at birth

1.1.8.5. Forename of mother

1.2. Additional information on the person

1.2.1. Nationality

1.2.2. Status of the person

1.2.3. Please fill in the following if "Status of the person" = "Other" :

1.2.3.1. Other status

1.2.4. Address of the person

1.2.4.1. Type of address

1.2.4.2. Address

1.2.4.2.1. Street

1.2.4.2.2. Building Name

1.2.4.2.3. Town *

1.2.4.2.4. Postal Code

1.2.4.2.5. Region

1.2.4.2.6. Country *

1.2.5. Pursues a professional or trade activity

{{metaSection.pursuesAProfessionalOrTradeActivityIndicator.$$error}} {{metaSection.pursuesAProfessionalOrTradeActivityIndicator.$$warning}}

2. Please send us information on periods which the person named in section 1 has completed

2.1. Periods of employment

2.1.1. Start Date *

2.1.2. End Date *

2.1.Periods of employment

2.2. Periods of self-employment

2.2.1. Start Date *

2.2.2. End Date *

2.2.Periods of self-employment

2.3. Periods of residence

2.3.1. Start Date *

2.3.2. End Date *

2.3.Periods of residence

2.4. Address(es) of residence in the country of receiving institution known to the sending institution

2.4.1. Street

2.4.2. Building Name

2.4.3. Town *

2.4.4. Postal Code

2.4.5. Region

2.4.6. Country *

2.4.Address(es) of residence in the country of receiving institution known to the sending institution

3. Additional Information

3.1. Additional Information

4. Please find attached following document(s)

4.1. Attached document(s)

4.2. Other document(s)

{{ row.severityMessage }} : {{ row.message }}

M052 - Request for information on employment/self-employment/residence periods - special non-contributory cash benefits Article 70 of Regulation (EC) No 883/2004

M052 - Request for information on employment/self-employment/residence periods - special non-contributory cash benefits
Article 70 of Regulation (EC) No 883/2004